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Ann Thorac Surg 1987;43:341-347
© 1987 The Society of Thoracic Surgeons

Articles

Legionnaires' Disease: An Emerging Surgical Problem

Joyce A. Korvick, M.D., Victor L. Yu, M.D.*

From the Infectious Disease Section, Veterans Administration Medical Center, and the University of Pittsburgh, Pittsburgh, PA

* Address reprint requests to Dr. Yu, Veterans Administration Medical Center, Infectious Disease Section, University Drive C, Pittsburgh, PA 15240

Legionnaires' disease is an important, although often overlooked, complication in the patient postoperatively. Up to 50% of all nosocomial legionellosis in the hospitals reviewed was found in surgical patients. Patients undergoing a transplant procedure are at highest risk, but occurrence is common in the surgical patient undergoing general anesthesia, endotracheal intubation, or both. Aerosolization, aspiration, and direct instillation of contaminated water during manipulation of the respiratory tract are likely mechanisms of transmission. The usual clinical presentation is that of a nonspecific pneumonia. Specialized laboratory techniques including selective culture media, direct fluorescent antibody stains, and serological detection of antibodies are necessary for accurate diagnosis. If these tests are not routinely available, Legionnaires' disease may remain undiagnosed. Environmental surveillance of the hospital water distribution system is advisable for hospitals with a large surgical case load. If transplantation is performed, such surveillance is mandatory.




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P. C. Luck, H.-M. Wenchel, and J. H. Helbig
Nosocomial Pneumonia Caused by Three Genetically Different Strains of Legionella pneumophila and Detection of These Strains in the Hospital Water Supply
J. Clin. Microbiol., April 1, 1998; 36(4): 1160 - 1163.
[Abstract] [Full Text] [PDF]


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